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Biomedical subjects

M Jaffe

Publications and source records attributed to M Jaffe.

At least 55 records · Page 3Linked to original sources
PubMed1994

Unexpected death in infancy. An epidemiologic study in the Haifa district, Israel.

The incidence of unexpected death in infancy (UDI) (2 weeks-12 months) in the Haifa area is 1.17 per 1000 live births. We found a significant interethnic difference between Israeli Jews and Arabs. The incidence among Arabs was 4 per 1000, but was only 0.77 per 1000 among Jews (p < 0.01). When the UDI Jewish group was compared to both the group of infants dying of known causes and the surviving group, the only significant factors related to UDI were found to be: young maternal age and low maternal education. No such association was evident among Arabs. Following logistic regression analysis, low maternal age and low socioeconomic status, but not ethnicity, were significantly associated with UDI as compared to the non-UDI infants. In comparison to non-UDI, UDI was significantly more prevalent during the cold season. UDI incidence has apparently been stable over the past 15 years. Demographic risk factors are similar to those reported from other communities, and ethnicity is possibly mediated through those factors.

Age Distribution↗
PubMed1994

Infrainguinal revascularization in end-stage renal disease.

Patients with end-stage renal disease are being maintained for longer periods with dialysis or renal transplantation. Although renal failure itself is associated with occlusive peripheral vascular disease, such patients often have additional comorbid risk factors. In this series, 88% of patients were diabetic, 93% were hypertensive, and 44% were smokers, all factors that exacerbate the severity of their vasculopathy. As a consequence, the vascular surgeon is increasingly being confronted with limb-threatening peripheral vascular disease in this population. We performed 34 infrainguinal bypasses in 27 patients during a 8-year period from 1986 to 1993. Fifty percent of these were bypasses to the infrapopliteal level. The 12- and 48-month graft patency was 64% and 38%, respectively, by life-table analysis. The limb salvage rate was 65% and 58% at 12 and 48 months. The perioperative mortality rate was 5.9% and the morbidity rate was 37%. Most of the limb loss (66%) occurred during the first 3 months after surgery as a result of acute graft occlusion or nonhealing of an ulcer or minor amputation site. We believe that this reflects an increasingly aggressive approach to limb salvage in patients with end-stage renal disease. Four limbs were lost despite a patent graft. Infrainguinal bypass is a viable management option for limb salvage in patients with end-stage renal disease. These procedures can be undertaken with acceptable perioperative mortality and with a 12-month limb salvage rate of 65%.

Adult↗
PubMed1994

Relationship between the parachute reactions and standing and walking in normal infants.

Assumption of the vertical position and independent walking are potentially hazardous motor milestones in the developing infant. It has been presumed that the parachute reactions evolved to protect infants from injury during this developmental stage. To determine the relationship between the appearance of the upper and lower parachute reactions and the developmental milestones of unsupported standing and independent walking, 190 normal infants were prospectively studied. The upper parachute reaction was found to precede the lower by less than a month (mean age of appearance: 8.9 and 9.2 months, respectively). More than one-half of the cohort achieved standing without either the upper (49%) or lower parachute reaction (57%); however, no independent walking occurred without the upper parachute reaction, and only 2 of 190 infants (1%) walked independently without the lower parachute reaction. Onset of walking occurred about 4 months after the appearance of the upper parachute reaction. The significance of these findings is discussed.

Accidental Falls↗
PubMed1994

[Endoscopic acromioplasty in total rupture of the rotator cuff].

PURPOSE OF THE STUDY: The authors have conducted a study to evaluate the possible efficacy of endoscopic decompression without repair in the treatment of rotator cuff tears. MATERIAL AND METHOD: We report 42 cases of endoscopic acromioplasty realized for full-thickness rotator cuff tears. Mean follow-up was 28.8 months. The principal presenting symptom was pain, with a mean duration of 29 months. Antero-external acromioplasty was realized by endoscopy using motorized drill bits, with sectioning or resecting the acromio-coracoid ligament. Revision consisted of a standard clinical examination, following the protocol of Constant, and a radiologic examination by sub-acromial frontal and scapular profile x-rays as advised by Liotard. RESULTS: The functional results were very good, with 94 per cent of patients satisfied. The mean Constant score was 67.4 (14-100) corresponding on the average to 84 per cent of the score of a healthy shoulder for the same age and sex. The improvement concerned essentially the score of the pain, which increased on the average 7.4 points out of 15 (10.2/15 at revision) and of the activity level (14.8/20 as opposed to 8/20 initially). Less important was the improvement of the active mobility score (from 25.2 to 34/40 at revision). The force was measured according to the Constant scale, with a mean of 8.3 points out of 25. The mean duration of absence from work for the active patients was 2.4 months. Neither infectious nor neurological complications were noted. The radiographic analysis showed a decrease of the acromial edge, significative as compared to the opposite side. On the profile x-ray, we observed 48 per cent flat acromions in contrast to 80 per cent curved types on the opposite side. The only element influencing the pain score was the size of the rupture, but the statistical result was weak. The final Constant score was strongly influenced by by the size of the rupture, the active mobility, the pre-operative active and passive mobility, as well as by the presence of head excentration on pre-operative x-rays. DISCUSSION: Comparison with other series of endoscopic acromioplasty for full-thickness rotator cuff tears has permitted us to confirm the validity of our series. We have especially evaluated this series in comparison to those with surgical repair. The subjective results, as well as those for pain, are equivalent; results on active mobility and force were not as good. We propose, therefore, this technique of low morbidity, in the presence of total ruptures in older and sedentary patients. The antalgic effect of endoscopic acromioplasty allows, in these patients, a functionally satisfying rehabilitation.

Acromion↗
PubMed1993

The effects of illness on sleep behaviour in infants.

For the purpose of evaluating the association between health problems and sleep disturbances as part of a community survey of sleep patterns in childhood, a questionnaire was administered to 752 mothers of children between the ages of 4 months and 4 years, and to the nurses at their regular baby clinics. The questionnaire covered the areas of past and present sleep and settling behaviour, as well as health history and demographic data. The study group consisted of 66 (8.9%) children who had either chronic medical problems, or history of an illness requiring hospitalisation. Regular night waking was reported in 35% and 34% of the group with and without history of illness, respectively. The mean number of interrupted nights per week was similar in both groups and so were the sleep problems perceived by the mothers. We conclude that in this age group the results do not support an association between health problems and prolonged sleep disturbances.

Case-Control Studies↗
PubMed1993

An effective community-based approach to the identification of neurodevelopmental delay in childhood.

The contribution of specially trained developmental nurses (DNs) to the accuracy of developmental screening in well-baby units was assessed. Of 13,580 children between two and 48 months of age, the well-baby clinic identified definitive developmental delay in 310, and 357 children were classified as 'questionable'. After DN assessment at 12 months follow-up, only 31 per cent of the questionable group required referral to the Child Development Centre (CDC). Comparison of the original queried recommendations to the CDC with the DN's recommendation indicated a false-positive and -negative rate of 60 and 20 per cent, respectively. This procedure resulted in false-positive and -negative screening accuracies of 1.2 and 6 per cent, respectively, for the total cohort of children screened. The economic and clinical advantages of this model are discussed.

Child Development↗
PubMed1993

Sleep characteristics of asthmatics in the first four years of life: a comparative study.

The association between asthma and sleep disturbances was assessed as part of a community survey of sleep patterns in children aged 4-48 months. A questionnaire covering the area of past and present sleep and settling behaviour, as well as health history and demographic data, was administered to 752 mothers of children visiting 14 well baby clinics. Fifty one (6.8%) of the children who were diagnosed as having asthma by their paediatricians were compared with the remaining healthy controls (children with perinatal problems, other chronic illnesses, developmental problems, or repeat admissions to hospital were excluded). Thirty nine per cent of the children with asthma and 38% of the normal controls were identified as regular wakers. The number of interrupted nights each week, settling time, and sleep duration were comparable. In the children with asthma an uninterrupted night's sleep was acquired later than in the control group. Parental perception of the severity of the sleep problem was similar in the two groups, as were the calming techniques. It is concluded that this study does not support a significantly increased prevalence of sleep disturbances among young children with asthma compared with their healthy peers.

Asthma↗
PubMed1993

Developmental disabilities among children between birth and 3 years old in the Haifa district: a population study.

The incidence of major neurodevelopmental deficits among children between birth and 3 years of age in the Haifa district was evaluated. Routine standardized developmental screening at the well-baby clinics was employed. The records of all children referred to the only two child developmental centers in the district during a period of 4 years were analyzed. The overall incidence was 31 per 1000 and was lower than expected. The age at diagnosis and associated disorders are discussed. In 30% of the cohort the diagnosis was inaccurate, and a 22% false positive referral rate was noted. A more thorough training in the early diagnosis of psychomotor developmental problems in childhood in the well-baby clinics is indicated.

Child Behavior Disorders↗
PubMed1992

Variability in head circumference growth rate during the first 2 years of life.

The head circumference (HC) curves were plotted for a group of 415 healthy full-term babies over the first 2 years of life. Two hundred ten (51%) of the cohort demonstrated HC variability, defined as an HC acceleration or deceleration of at least 1 centile curve for at least 2 months. Of these, the deceleration pattern was predominant (80.9%), and also frequently permanent (87%). The HCs of 3 (1.42%) of 210 infants with HC variability ended up with a deviation of 2 standard deviations or more from the mean. The onset of HC transition occurred from the mean age of 1.3 months, and the new curve had stabilized by age 13 months in 95% of the study group. Parallel changes occurred in body weight and body length in approximately 48% of the total cohort, but more frequently in the variable-HC group. The clinical interpretation of these findings is discussed.

Body Height↗
PubMed1991

High dose intravenous gamma-globulin in intractable epilepsy of childhood.

Eight children aged between 1.3 and 13 years suffering from epilepsy refractory to conventional anticonvulsive therapy were treated with high dose intravenous gamma globulin (200 mg/kg, 3 times per week, repeated after 3 weeks). Immunological studies after therapy showed normal results. In four children, clinical and EEG findings markedly improved. In one other case a partial response was noted. No improvement was observed in the remaining three cases. We confirm that although the mechanism is still obscure, high doses of i.v. gammaglobulin may have a beneficial effect in a significant number of children with intractable epilepsy.

Adolescent↗
PubMed1991

Preservation of regional myocardial ultrasonic backscatter and systolic function during brief periods of ischemia by synchronized coronary venous retroperfusion.

This study examines the effects of brief periods of ischemia on average and cardiac cycle-dependent variation of regional ultrasonic backscatter paralleled with changes in regional myocardial contraction, and to what extent these changes could be reversed by synchronized coronary venous retroperfusion. In five closed-chest dogs, the left anterior descending coronary artery was occluded on four occasions for a 2-minute period and retroperfusion was applied randomly to two of the coronary occlusions. Complete functional recovery was allowed between the occlusions. Two-dimensional echocardiographic images were obtained before and at the peak of the 2-minute occlusion period. Regional myocardial contraction as measured by fractional area change and systolic wall thickening during untreated occlusions decreased from 33.9 +/- 14.0% to -0.15 +/- 6.2%, and from 22.0 +/- 1.8% to -17.9 +/- 2.2%, whereas during retroperfusion-treated occlusions it changed from 37.4 +/- 8.5% to only 23.4 +/- 11.2% (p less than 0.005 versus baseline), and from 24.1 +/- 2.8% to only 12.7 +/- 2.0% (p less than 0.005 versus baseline), corresponding to a preservation of 62% and 52% of baseline regional contraction, respectively. Average regional gray level (arbitrary units) during untreated coronary occlusions exhibited a significant increase in the ischemic regions, from 5.6 +/- 2.7 at baseline to 11.5 +/- 4.4 during occlusion (p less than 0.005); during retroperfusion-treated occlusions, average gray level increased from 4.7 +/- 3.6 to only 6.3 +/- 3.6 (NS). Untreated coronary artery occlusions resulted in a systolic increase in gray level in the ischemic region, followed by a diastolic decrease.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Prognosis of motor development and joint hypermobility.

In a study of 59 infants aged 18 months there were 20 with joint hypermobility and delayed motor development, 19 with joint hypermobility and normal motor development, and 20 normal controls. They were reassessed for motor function 3.5 years later at the age of 5 years. Both gross and fine motor performance were significantly delayed in the group of children who exhibited joint hypermobility and motor delay in infancy. No significant delay was evident in those with joint hypermobility only. Joint hypermobility resolved more frequently in children who presented normal motor development at age 18 months. Infants with joint hypermobility and motor delay are a subgroup associated with a less favourable motor outcome and careful follow up is indicated.

Attitude to Health↗
PubMed1991

Relationship between neonatal excitability and respiratory habituation.

The Brazelton Neonatal Behavioral Assessment Scale was administered and analyzed in the cases of 25 full-term infants in order to assess the relationship between a behavioral measure of excitability and respiratory habituation. Sound and light stimuli were sequentially delivered, and prestimulus and poststimulus respiratory amplitude mean and standard deviation were analyzed. The stimulus with the least interperiod difference was considered as habituation. The correlation between arousal behavioral items and respiratory habituation ranged between 0.16 and 0.44. The two significant correlations were between peak of excitement and respiratory habituation to light (0.44) and between rapidity of buildup and respiratory habituation to sound (0.38). These results may indicate an interrelation in neonates between temperamental excitability attributes and respiratory regulation.

Acoustic Stimulation↗
PubMed1991

Brucellosis as a cause of severe colitis.

A 16-yr-old girl presented with osteomyelitis and massive rectal bleeding. Colonoscopy revealed severe nonspecific colitis. Multiple laboratory investigations failed to disclose the etiology of either the bone or colon infections. Empiric treatment with corticosteroids and sulfasalazine resulted in only transient improvement. One month after discharge, her original symptoms recurred. Blood and pus cultures at this time yielded Brucella melitensis. After tetracycline treatment, the patient recovered. At 1-yr follow-up, she was found completely asymptomatic. Although osteomyelitis is a well-known manifestation of brucellosis, colitis related to this agent has so far not been described.

Adolescent↗